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Timeline of changes in appetite during weight loss with a ketogenic diet.

ABSTRACT: BACKGROUND/OBJECTIVE:Diet-induced weight loss (WL) leads to increased hunger and reduced fullness feelings, increased ghrelin and reduced satiety peptides concentration (glucagon-like peptide-1 (GLP-1), cholecystokinin (CCK) and peptide YY (PYY)). Ketogenic diets seem to minimise or supress some of these responses. The aim of this study was to determine the timeline over which changes in appetite occur during progressive WL with a ketogenic very-low-energy diet (VLED). SUBJECTS/METHODS:Thirty-one sedentary adults (18 men), with obesity (body mass index: 37±4.5?kg?m-2) underwent 8 weeks (wks) of a VLED followed by 4 wks of weight maintenance. Body weight and composition, subjective feelings of appetite and appetite-related hormones (insulin, active ghrelin (AG), active GLP-1, total PYY and CCK) were measured in fasting and postprandially, at baseline, on day 3 of the diet, 5 and 10% WL, and at wks 9 and 13. Data are shown as mean±s.d. RESULTS:A significant increase in fasting hunger was observed by day 3 (2±1% WL), (P<0.01), 5% WL (12±8 days) (P<0.05) and wk 13 (17±2% WL) (P<0.05). Increased desire to eat was observed by day 3 (P<0.01) and 5% WL (P<0.05). Postprandial prospective food consumption was significantly reduced at wk 9 (16±2% WL) (P<0.01). Basal total PYY was significantly reduced at 10% WL (32±8 days) (P<0.05). Postprandial active GLP-1 was increased at 5% WL (P<0.01) and CCK reduced at 5 and 10% WL (P<0.01, for both) and wk 9 (P<0.001). Basal and postprandial AG were significantly increased at wk 13 (P<0.001, both). CONCLUSIONS:WL with a ketogenic VLED transiently increases the drive to eat up to 3 weeks (5% WL). After that, and while participants are ketotic, a 10-17% WL is not associated with increased appetite. However, hunger feelings and AG concentrations increase significantly from baseline, once refeeding occurs.

SUBMITTER: Nymo S

PROVIDER: S-EPMC5550564 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Timeline of changes in appetite during weight loss with a ketogenic diet.

Nymo S S Coutinho S R SR Jørgensen J J Rehfeld J F JF Truby H H Kulseng B B Martins C C

International journal of obesity (2005) 20170425 8

<h4>Background/objective</h4>Diet-induced weight loss (WL) leads to increased hunger and reduced fullness feelings, increased ghrelin and reduced satiety peptides concentration (glucagon-like peptide-1 (GLP-1), cholecystokinin (CCK) and peptide YY (PYY)). Ketogenic diets seem to minimise or supress some of these responses. The aim of this study was to determine the timeline over which changes in appetite occur during progressive WL with a ketogenic very-low-energy diet (VLED).<h4>Subjects/method ...[more]

PMID: 28439092

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Project description:Background:Reductions in energy intake are seen in weight loss trials, but whether this occurs with improvements to diet quality (DQ) is less established. The aim of this study was to evaluate changes in diet quality in a sample of volunteers in a weight loss trial. Methods:This was a secondary analysis of dietary data from a lifestyle intervention trial (the HealthTrack study) which advised on dietary guidelines. The trial ran for 12 months with three treatment groups: control (general advice C), intervention (individualised advice, I), and intervention plus a supplement of walnuts (IW). Both the published a priori diet quality score (APDQS, maximum score 164) and a study specific Diet Quality Tracker (DQT, maximum score 44) indicated compliance to dietary advice. DQ scores calculated at 0, 3months and 12months were evaluated using two-way RMANOVA, one-way ANOVA and one-way RMANOVA. Changes in intakes of food groups and nutrients were analysed using Kruskal-Wallis and Friedman's tests. Results:There were no differences between groups at baseline, but at 3months IW recorded higher DQ scores (APDQS:96?±?10; DQT:22?±?5, P?<?1?×?10-3 for both) compared to I (APDQS:91?±?13, P?<?1?×?10-3; DQT:21?±?4, P?<?1?×?10-2) and C (APDQS:87?±?12, P?<?5?×?10-2; DQT:19?±?4, P?>?5?×?10-2), and a higher consumption of nuts at 3 months (P?<?1?×?10-3), and 12months (P?<?1?×?10-2). All groups reported decreased intakes of discretionary foods/beverages assessed by the DQT (P?<?1?×?10-3 for IW and I; P?<?1?×?10-2 for C). The APDQS showed this as reduced intakes of grain based desserts (P?<?1?×?10-3 at 3 and 12months), and salty snacks at 12months (P?<?1?×?10-3 for IW and I; P?<?5?×?10-2 for C). Intakes of monounsaturated and saturated fatty acids were lowest, and polyunsaturated fatty acids highest for IW (P?<?1?×?10-3), resulting in a higher dietary polyunsaturated:saturated fat ratio (P?<?1?×?10-3). Conclusions:Lifestyle intervention addressing dietary guidelines can lead to significant reductions in consumption of discretionary foods and saturated fat, but individualised advice may have a greater impact on improving overall DQ regardless of DQI used. Providing a healthy food supplement may help assure higher DQ and where the food is walnuts, produce commensurate differences in dietary fatty acid profiles. Trial registration:ANZCTRN 12614000581662. Date of registration: 30th May 2014.

Project description:BACKGROUND/OBJECTIVE:Diet-induced weight loss (WL) leads to a compensatory increase in appetite and changes in the plasma concentration of appetite-regulating hormones are likely to play a role. Whether these changes are transient or sustained remains unclear. This study aimed to assess if changes in subjective and objective appetite markers observed with WL are sustained after 1 year (1Y). SUBJECTS/METHODS:In total 100 (45 males) individuals with obesity (BMI: 37?±?4?kg/m2, age: 43?±?10 years) underwent 8 weeks (wks) of a very-low energy diet (VLED), followed by 4 wks refeeding, and a 1Y maintenance program. Fasting/postprandial subjective ratings of hunger, fullness, desire to eat, and prospective food consumption (PFC) were assessed, and plasma concentration of active ghrelin (AG), total peptide YY (PYY), active glucagon-like peptide 1, cholecystokinin (CCK), and insulin measured, at baseline, week 13 (Wk13) and 1Y. RESULTS:At Wk13, 16% WL (-18?±?1?kg, P?<?0.001) was associated with a significant increase in fasting and postprandial hunger ratings (P?<?0.01 and P?<?0.05, respectively), and postprandial fullness (P?<?0.01) combined with a reduction in PFC (P?<?0.001). These were accompanied by a significant rise in basal and postprandial AG concentrations (P?<?0.001, for both), a reduction in postprandial CCK (P?<?0.01) and in basal and postprandial insulin (P?<?0.001). At 1Y follow-up, with sustained WL (15%; -16?±?1?kg, P?<?0.001), fasting hunger and postprandial fullness ratings remained increased (P?<?0.05 for both), and postprandial PFC reduced (P?<?0.001). Basal and postprandial AG remained elevated and insulin reduced (P?<?0.001, for all), while postprandial CCK was increased (P?<?0.01) and PYY decreased (P?<?0.001). CONCLUSION:With a 15% sustained WL at 1Y, the drive to eat in the fasting state is increased, but this may be balanced out by raised postprandial feelings of fullness. To assist with WL maintenance, new strategies are required to manage increased hunger and drive to eat.

Project description:BackgroundDiet-induced weight loss (WL) is usually accompanied by increased appetite, a response that seems to be absent when ketogenic diets are used. It remains unknown if sex modulates the appetite suppressant effect of ketosis.ObjectiveThe aim of this study was to examine if sex modulates the impact of WL-induced changes in appetite and if ketosis alters these responses.MethodsNinety-five individuals (55 females) with obesity (BMI [kg/m 2]: 37 ± 4) underwent 8 wk of a very-low-energy diet, followed by 4 wk of refeeding and weight stabilization. Body composition, plasma concentration of β-hydroxybutyrate (β-HB) and appetite-related hormones (active ghrelin, active glucagon-like peptide 1 [GLP-1], total peptide YY [PYY], cholecystokinin and insulin), and subjective feelings of appetite were measured at baseline, week 9 in ketosis, and week 13 out of ketosis.ResultsThe mean WL at week 9 was 17% for males and 15% for females, which was maintained at week 13. Weight, fat, and fat-free mass loss were greater in males (P < 0.001 for all) and the increase in β-HB at week 9 higher in females (1.174 ± 0.096 compared with 0.783 ± 0.112 mmol/L, P = 0.029). Basal and postprandial GLP-1 and postprandial PYY (all P < 0.05) were significantly different for males and females. There were no significant sex × time interactions for any other appetite-related hormones or subjective feelings of appetite. At week 9, basal GLP-1 was decreased only in males (P < 0.001), whereas postprandial GLP-1 was increased only in females (P < 0.001). No significant changes in postprandial PYY were observed over time for either sex.ConclusionsKetosis appears to have a greater beneficial impact on GLP-1 in females. However, sex does not seem to modulate the changes in the secretion of other appetite-related hormones, or subjective feelings of appetite, seen with WL, regardless of the ketotic state. This trial was registered at clinicaltrials.gov as NCT01834859.

Project description:The prevalence of obesity has continued to rise over the past three decades leading to significant increases in obesity-related medical care costs from metabolic and non-metabolic sequelae. It is now clear that expansion of body fat leads to an increase in inflammation with systemic effects on metabolism. In mouse models of diet-induced obesity, there is also an expansion of bone marrow adipocytes. However, the persistence of these changes after weight loss has not been well described. The objective of this study was to investigate the impact of high-fat diet (HFD) and subsequent weight loss on skeletal parameters in C57Bl6/J mice. Male mice were given a normal chow diet (ND) or 60% HFD at 6 weeks of age for 12, 16, or 20 weeks. A third group of mice was put on HFD for 12 weeks and then on ND for 8 weeks to mimic weight loss. After these dietary challenges, the tibia and femur were removed and analyzed by micro computed-tomography for bone morphology. Decalcification followed by osmium staining was used to assess bone marrow adiposity, and mechanical testing was performed to assess bone strength. After 12, 16, or 20 weeks of HFD, mice had significant weight gain relative to controls. Body mass returned to normal after weight loss. Marrow adipose tissue (MAT) volume in the tibia increased after 16 weeks of HFD and persisted in the 20-week HFD group. Weight loss prevented HFD-induced MAT expansion. Trabecular bone volume fraction, mineral content, and number were decreased after 12, 16, or 20 weeks of HFD, relative to ND controls, with only partial recovery after weight loss. Mechanical testing demonstrated decreased fracture resistance after 20 weeks of HFD. Loss of mechanical integrity did not recover after weight loss. Our study demonstrates that HFD causes long-term, persistent changes in bone quality, despite prevention of marrow adipose tissue accumulation, as demonstrated through changes in bone morphology and mechanical strength in a mouse model of diet-induced obesity and weight loss.

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Timeline of changes in appetite during weight loss with a ketogenic diet.

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Timeline of changes in appetite during weight loss with a ketogenic diet.

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